Provider Demographics
NPI:1972294148
Name:MEYERS, RYAN ANDREW (CPHT)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:ANDREW
Last Name:MEYERS
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 NE HIGHWAY 99W
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-2793
Mailing Address - Country:US
Mailing Address - Phone:503-472-2133
Mailing Address - Fax:503-472-4130
Practice Address - Street 1:448 NE HIGHWAY 99W
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-2793
Practice Address - Country:US
Practice Address - Phone:503-472-2133
Practice Address - Fax:503-472-4130
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT-0003624183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician